Many seniors dread visiting their doctor for their licence renewal once they reach 75 years of age, and then biannually from age 80. This is because many GP clinics are now utilising a memory/cognitive test to decide whether or not a driving licence should be renewed. Many of us have poor memories but are still competent and safe drivers.
A Radio NZ Nine to Noon interview, on the 30th April, with Dr Alexander Crizzle, who has extensively researched the value of cognitive tests to predict practical driving skills, concluded that they were a poor predictor, and that many of those who failed would have passed a practical driving assessment. Dr Crizzle is Director of the Driving Simulation Laboratory, School of Public Health at the University of Saskatchewan, and has published extensively on these issues. https://www.rnz.co.nz/national/programmes/ninetonoon/audio/2018936315/cognitive-tests-assessing-driver-impairment-in-question
David Marshall, Acting-President of Grey Power NZ Federation, explains that the consequences can be devastating for seniors who often feel demeaned by having to remember addresses and grocery items that have zero relevance to their driving ability, and often no questions on the road code, or their driving history and accident record.
When a GP fails a patient they may be referred for an on-road driving test, or to an Occupational Therapist for a full evaluation. This creates more stress on an overloaded system – especially when a significant proportion will pass their practical driving assessment.
The on-road safety test is only available through certain centres, so those in smaller towns or in rural areas may be forced to travel 40 km or more to sit a practical test in an area that is unfamiliar to them when feeling stressed at the potential cancelling of their licence. Some of our members have given up persevering to renew their licence and are often resentful at the way they have been treated after years of safe driving. Waits of 2 months or more to secure an appointment are not uncommon, so a temporary licence needs to be re-issued. Grey Power wants to see this service expanded so those referred can be assessed within their own locality. This could be potentially facilitated if licensed driving instructors, who teach our young people to drive, were also certified to conduct an on-road safety test.
For those referred to an Occupation Therapist, the costs are a significant barrier to many seniors who are dependent on NZ Super as their sole income. Our members have reported costs of $700-$1200 just for the assessment. For those referred again 2 years later the cost and effort often results in them reluctantly surrendering their licence and losing their social connectivity.
The situation around New Zealand is highly variable, as shown in a recent survey of Grey Power members 75 years of age or older. There is no consistency as to how seniors are evaluated by their GP. Some GPs conduct routine tests such as eyesight, ask how their patient is feeling, and then sign off the statutory form. At the other extreme some practices have made a cognitive test (such as the Mini-ACE) a mandatory part of every evaluation. The hurdle to licence renewal for seniors is wildly inconsistent nationally.
With NZTA currently reviewing their guidelines for assessing seniors for licence renewals, Grey Power urges that they work collaboratively with GPs, senior advocacy groups such as Grey Power and organisations like AA to develop simpler transparent guidelines for GPs.
Grey Power urges that a cognitive test is never mandatory and is only used as another tool in patients where there is a suspicion of early dementia. To utilise cognitive tests in all patients is demeaning and creating an unnecessary burden on both seniors and our other assessment systems.
David Marshall
Acting-President/Vice President
Grey Power NZ Federation Inc
Office: PO Box 2721719, Papakura 2244
Office Phone: 09 299 2113
Office Email: fed-office@greypower.co.nz
Internet Site: www.greypower.co.nz